Background
Methods
Study design
Study outcomes
Covariates
Statistical analysis
NOACs | NOACs (A + D+R + E) (n = 20,967) | Warfarin (n = 5812) | ASMD | ||||
---|---|---|---|---|---|---|---|
Apixaban n = 3249 | Dabigatran n = 6531 | Edoxaban n = 1389 | Rivaroxaban n = 9798 | NOACs | |||
Vs. | |||||||
Warfarin | |||||||
Age | |||||||
(Mean ± STD) | 76 ± 9.7 | 74 ± 9.7 | 75.4 ± 9.7 | 75.5 ± 9.7 | 75.1 ± 9.8 | 72.5 ± 11.6 | 0.2406 |
< 65 | 428 (13.2%) | 1114 (17.1%) | 196 (14.1%) | 1345 (13.7%) | 3083 (14.7%) | 1664 (28.6%) | 0.3470 |
65–74 | 976 (30%) | 2229 (34.1%) | 427 (30.7%) | 3033 (31%) | 6665 (31.8%) | 1446 (24.9%) | |
75–84 | 1210 (37.2%) | 2354 (36%) | 539 (38.8%) | 3766 (38.4%) | 7869 (37.5%) | 1848 (31.8%) | |
> 85 | 635 (19.5%) | 834 (12.8%) | 227 (16.3%) | 1654 (16.9%) | 3350 (16%) | 854 (14.7%) | |
Male | 1704 (52.5%) | 3800 (58.2%) | 756 (54.4%) | 5045 (51.5%) | 11,305 (53.9%) | 3080 (53%) | 0.0185 |
CHA2DS2-VASc (mean ± STD) | 4.7 ± 1.6 | 4.4 ± 1.6 | 4.5 ± 1.5 | 4.6 ± 1.6 | 4.5 ± 1.6 | 4.2 ± 1.8 | 0.1890 |
HAS-BLED (mean ± STD) | 3.2 ± 1 | 3 ± 1 | 3.2 ± 1.1 | 3.1 ± 1 | 3.1 ± 1 | 2.9 ± 1.2 | 0.2299 |
Hypertension | 2697 (83%) | 5206 (79.7%) | 1164 (83.8%) | 7922 (80.9%) | 16,989 (81%) | 4446 (76.5%) | 0.1109 |
Dyslipidemia | 2200 (67.7%) | 4102 (62.8%) | 1011 (72.8%) | 6425 (65.6%) | 13,738 (65.5%) | 3409 (58.7%) | 0.1419 |
Chronic live disease | 455 (14%) | 834 (12.8%) | 219 (15.8%) | 1345 (13.7%) | 2853 (13.6%) | 779 (13.4%) | 0.0060 |
Chronic kidney disease | 880 (27.1%) | 1164 (17.8%) | 425 (30.6%) | 2295 (23.4%) | 4764 (22.7%) | 1371 (23.6%) | 0.0206 |
Chronic lung disease | 413 (12.7%) | 739 (11.3%) | 165 (11.9%) | 1389 (14.2%) | 2706 (12.9%) | 792 (13.6%) | 0.0213 |
Gout | 719 (22.1%) | 1166 (17.9%) | 328 (23.6%) | 1994 (20.4%) | 4207 (20.1%) | 1113 (19.2%) | 0.0230 |
Congestive heart failure | 438 (13.5%) | 684 (10.5%) | 175 (12.6%) | 1324 (13.5%) | 2621 (12.5%) | 919 (15.8%) | 0.0951 |
Chronic ischemic heart disease | 498 (15.3%) | 764 (11.7%) | 210 (15.1%) | 1437 (14.7%) | 2909 (13.9%) | 844 (14.5%) | 0.0186 |
Peripheral artery disease | 296 (9.1%) | 616 (9.4%) | 132 (9.5%) | 959 (9.8%) | 2003 (9.6%) | 544 (9.4%) | 0.0066 |
Stroke | 730 (22.5%) | 1597 (24.5%) | 205 (14.8%) | 2259 (23.1%) | 4791 (22.9%) | 1034 (17.8%) | 0.1260 |
Malignancy | 370 (11.4%) | 573 (8.8%) | 165 (11.9%) | 1059 (10.8%) | 2167 (10.3%) | 574 (9.9%) | 0.0152 |
PCI | 330 (10.2%) | 417 (6.4%) | 149 (10.7%) | 868 (8.9%) | 1764 (8.4%) | 510 (8.8%) | 0.0129 |
CABG | 31 (1%) | 25 (0.4%) | 10 (0.7%) | 71 (0.7%) | 137 (0.7%) | 90 (1.6%) | 0.0859 |
History of bleeding | 74 (2.3%) | 117 (1.8%) | 24 (1.7%) | 222 (2.3%) | 437 (2.1%) | 148 (2.6%) | 0.0307 |
Use of NSAIDs | 918 (28.3%) | 1551 (23.8%) | 389 (28%) | 2581 (26.3%) | 5439 (25.9%) | 1546 (26.6%) | 0.0150 |
Use of PPI | 451 (13.9%) | 622 (9.5%) | 174 (12.5%) | 1187 (12.1%) | 2434 (11.6%) | 887 (15.3%) | 0.1073 |
Use of H2 blocker | 1132 (34.8%) | 2068 (31.7%) | 463 (33.3%) | 3201 (32.7%) | 6864 (32.7%) | 2069 (35.6%) | 0.0604 |
Use of ACEI/ARB | 2205 (67.9%) | 4470 (68.4%) | 955 (68.8%) | 6731 (68.7%) | 14,361 (68.5%) | 3984 (68.6%) | 0.0012 |
Use of beta-blocker | 2031 (62.5%) | 3769 (57.7%) | 925 (66.6%) | 5939 (60.6%) | 12,664 (60.4%) | 3754 (64.6%) | 0.0866 |
Use of verapamil or diltiazem | 824 (25.4%) | 1505 (23%) | 260 (18.7%) | 2551 (26%) | 5140 (24.5%) | 1666 (28.7%) | 0.0940 |
Use of statin | 1600 (49.3%) | 2907 (44.5%) | 701 (50.5%) | 4574 (46.7%) | 9782 (46.7%) | 2263 (38.9%) | 0.1564 |
Use of APT | 480 (14.8%) | 1383 (21.2%) | 140 (10.1%) | 1926 (19.7%) | 3929 (18.7%) | 2063 (35.5%) | 0.3838 |
Use of metformin | 1503 (46.3%) | 3320 (50.8%) | 584 (42%) | 4488 (45.8%) | 9895 (47.2%) | 2567 (44.2%) | 0.0608 |
Use of SU | 1214 (37.4%) | 2675 (41%) | 454 (32.7%) | 3574 (36.5%) | 7917 (37.8%) | 2312 (39.8%) | 0.0415 |
Use of glinide | 293 (9%) | 498 (7.6%) | 99 (7.1%) | 846 (8.6%) | 1736 (8.3%) | 714 (12.3%) | 0.1321 |
Use of acarbose | 323 (9.9%) | 654 (10%) | 111 (8%) | 924 (9.4%) | 2012 (9.6%) | 645 (11.1%) | 0.0493 |
Use of glitazone | 185 (5.7%) | 381 (5.8%) | 68 (4.9%) | 463 (4.7%) | 1097 (5.2%) | 320 (5.5%) | 0.0121 |
Use of insulin | 927 (28.5%) | 1388 (21.3%) | 305 (22%) | 2601 (26.6%) | 5221 (24.9%) | 2008 (34.6%) | 0.2123 |
Use of SGLT2i | 63 (1.9%) | 54 (0.8%) | 48 (3.5%) | 106 (1.1%) | 271 (1.3%) | 20 (0.3%) | 0.1054 |
Results
NOACs | NOACs (A + D+R + E) (n = 20,967) | Warfarin (n = 5812) | ASMD | ||||
---|---|---|---|---|---|---|---|
Apixaban n = 3249 | Dabigatran n = 6531 | Edoxaban n = 1389 | Rivaroxaban n = 9798 | NOACs vs. Warfarin | |||
Age | |||||||
(Mean ± STD) | 75.6 ± 10 | 73.5 ± 10.1 | 74.9 ± 9.9 | 75 ± 10.1 | 74.6 ± 10.1 | 74.5 ± 10.3 | 0.0118 |
< 65 | 499.76 (15.6%) | 1329.46 (20.3%) | 226.27 (16.8%) | 1619.19 (16.5%) | 3674.69 (17.6%) | 992.87 (17.8%) | 0.0129 |
65–74 | 923.58 (28.8%) | 2109.08 (32.3%) | 396.11 (29.4%) | 2894.27 (29.5%) | 6323.04 (30.3%) | 1658.22 (29.8%) | |
75–84 | 1163.61 (36.3%) | 2278.34 (34.9%) | 506.75 (37.7%) | 3656.43 (37.3%) | 7605.13 (36.4%) | 2030.02 (36.4%) | |
> 85 | 620.66 (19.4%) | 818.07 (12.5%) | 216.63 (16.1%) | 1627.86 (16.6%) | 3283.22 (15.7%) | 891.61 (16%) | |
Male | 1673.4 (52.2%) | 3788.91 (58%) | 730.05 (54.3%) | 5027.21 (51.3%) | 11,219.58 (53.7%) | 2981.44 (53.5%) | 0.0044 |
CHA2DS2-VASc (mean ± STD) | 4.6 ± 1.6 | 4.3 ± 1.6 | 4.4 ± 1.5 | 4.5 ± 1.7 | 4.5 ± 1.6 | 4.4 ± 1.6 | 0.0184 |
HAS-BLED (mean ± STD) | 3.2 ± 1.1 | 3 ± 1.1 | 3.1 ± 1.1 | 3.1 ± 1.1 | 3.1 ± 1.1 | 3 ± 1.1 | 0.0491 |
Hypertension | 2646.3 (82.5%) | 5147.03 (78.8%) | 1117.08 (83%) | 7823.89 (79.9%) | 16,734.29 (80.1%) | 4438.09 (79.6%) | 0.0122 |
Dyslipidemia | 2131.33 (66.5%) | 4013.75 (61.4%) | 964.54 (71.7%) | 6272.89 (64%) | 13,382.51 (64.1%) | 3545.77 (63.6%) | 0.0094 |
Chronic live disease | 448.27 (14%) | 836.45 (12.8%) | 211.38 (15.7%) | 1335.81 (13.6%) | 2831.92 (13.6%) | 745.06 (13.4%) | 0.0056 |
Chronic kidney disease | 884.71 (27.6%) | 1165.76 (17.8%) | 411.07 (30.6%) | 2318.11 (23.7%) | 4779.66 (22.9%) | 1290.66 (23.2%) | 0.0066 |
Chronic lung disease | 415.03 (12.9%) | 751.11 (11.5%) | 161.41 (12%) | 1403.16 (14.3%) | 2730.7 (13.1%) | 747.12 (13.4%) | 0.0099 |
Gout | 706.18 (22%) | 1152.6 (17.6%) | 317.42 (23.6%) | 1975.72 (20.2%) | 4151.94 (19.9%) | 1105.89 (19.8%) | 0.0009 |
Congestive heart failure | 461.45 (14.4%) | 721.17 (11%) | 174.76 (13%) | 1401.59 (14.3%) | 2758.96 (13.2%) | 770.92 (13.8%) | 0.0185 |
Chronic ischemic heart disease | 490.98 (15.3%) | 764.79 (11.7%) | 206.47 (15.3%) | 1457.45 (14.9%) | 2919.68 (14%) | 740.87 (13.3%) | 0.0202 |
Peripheral artery disease | 294.56 (9.2%) | 615.97 (9.4%) | 126.94 (9.4%) | 961.97 (9.8%) | 1999.44 (9.6%) | 531.89 (9.5%) | 0.0010 |
Stroke | 693.74 (21.6%) | 1497.7 (22.9%) | 189.25 (14.1%) | 2161.77 (22.1%) | 4542.45 (21.8%) | 1175.9 (21.1%) | 0.0160 |
Malignancy | 365.73 (11.4%) | 562.12 (8.6%) | 160.26 (11.9%) | 1055.43 (10.8%) | 2143.54 (10.3%) | 578.15 (10.4%) | 0.0037 |
PCI | 324.92 (10.1%) | 414.45 (6.3%) | 143.9 (10.7%) | 889.57 (9.1%) | 1772.84 (8.5%) | 459.64 (8.3%) | 0.0088 |
CABG | 35.34 (1.1%) | 30.41 (0.5%) | 10.85 (0.8%) | 90.42 (0.9%) | 167.02 (0.8%) | 44.51 (0.8%) | 0.0001 |
History of bleeding | 77.02 (2.4%) | 118.84 (1.8%) | 24.55 (1.8%) | 229.26 (2.3%) | 449.66 (2.2%) | 119.51 (2.1%) | 0.0006 |
Use of NSAIDs | 908.1 (28.3%) | 1567.68 (24%) | 380.44 (28.3%) | 2591.36 (26.5%) | 5447.58 (26.1%) | 1477.57 (26.5%) | 0.0099 |
Use of PPI | 470.21 (14.7%) | 662.62 (10.1%) | 177.39 (13.2%) | 1261.57 (12.9%) | 2571.79 (12.3%) | 690.04 (12.4%) | 0.0021 |
Use of H2 blocker | 1136.31 (35.4%) | 2108.48 (32.3%) | 452.75 (33.6%) | 3266.7 (33.3%) | 6964.24 (33.3%) | 1891.32 (33.9%) | 0.0127 |
Use of ACEI/ARB | 2179.74 (68%) | 4473.09 (68.5%) | 923.23 (68.6%) | 6739.93 (68.8%) | 14,315.99 (68.5%) | 3807.33 (68.3%) | 0.0048 |
Use of beta-blocker | 2033.15 (63.4%) | 3832.74 (58.7%) | 905.14 (67.3%) | 6041.78 (61.7%) | 12,812.82 (61.4%) | 3462.48 (62.1%) | 0.0164 |
Use of verapamil or diltiazem | 835.94 (26.1%) | 1555.98 (23.8%) | 260.29 (19.3%) | 2647.44 (27%) | 5299.65 (25.4%) | 1421.74 (25.5%) | 0.0032 |
Use of statin | 1524.64 (47.5%) | 2787.22 (42.7%) | 662.45 (49.2%) | 4428.17 (45.2%) | 9402.48 (45%) | 2467.58 (44.3%) | 0.0150 |
Use of APT | 557.85 (17.4%) | 1634.37 (25%) | 163.4 (12.1%) | 2288.62 (23.4%) | 4644.24 (22.2%) | 1275.11 (22.9%) | 0.0156 |
Use of metformin | 1464.25 (45.7%) | 3276.26 (50.1%) | 551.96 (41%) | 4424.87 (45.2%) | 9717.34 (46.5%) | 2605.79 (46.8%) | 0.0047 |
Use of SU | 1213.44 (37.8%) | 2703.68 (41.4%) | 443.81 (33%) | 3613.42 (36.9%) | 7974.35 (38.2%) | 2150.56 (38.6%) | 0.0085 |
Use of glinide | 316.99 (9.9%) | 545.52 (8.4%) | 104.16 (7.7%) | 941.11 (9.6%) | 1907.78 (9.1%) | 524.66 (9.4%) | 0.0098 |
Use of acarbose | 327.99 (10.2%) | 675.87 (10.3%) | 110.92 (8.2%) | 954.94 (9.8%) | 2069.72 (9.9%) | 564.11 (10.1%) | 0.0072 |
Use of glitazone | 187.7 (5.9%) | 380.2 (5.8%) | 64.64 (4.8%) | 470.95 (4.8%) | 1103.49 (5.3%) | 294.35 (5.3%) | 0.0001 |
Use of insulin | 981.92 (30.6%) | 1499.29 (22.9%) | 316.6 (23.5%) | 2823.21 (28.8%) | 5621.01 (26.9%) | 1541.1 (27.7%) | 0.0168 |
Use of SGLT2i | 62.44 (2%) | 52.38 (0.8%) | 48.25 (3.6%) | 109.87 (1.1%) | 272.94 (1.3%) | 19.75 (0.4%) | 0.1057 |